Line lock threading systems and methods

ABSTRACT

A line lock includes a body at least partially bounding a plurality of passageways such that a suture can only be drawn through the passageways along one direction. The suture may be inserted through the passageways through the use of a cartridge designed to contain the line lock. Threaders may pass through the line lock within the cartridge. Each threader may have a leading end and a trailing end that can be coupled to a suture end. Thus, two suture ends may be drawn through the passageways by coupling them to the threaders and drawing the leading ends of the threaders to cause the suture ends to pass through the passageways according to the desired pattern. The cartridge may then be opened to permit easy removal of the suture and the line lock.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 10/459,375, filed on Jun. 11, 2003 and entitled ADJUSTABLE LINELOCKS AND METHODS, and a continuation-in-part of U.S. patent applicationSer. No. ______ [not received yet], which is identified by Applicants'Docket No. MLI-15, filed on Sep. 7, 2004 and entitled ADJUSTABLE LINELOCKS AND METHODS, the disclosures of which are incorporated herein byreference.

BACKGROUND OF THE INVENTION

1. The Field of the Invention

The present invention relates generally to devices to replace knots andmore specifically to devices to replace surgical knots tied in open,arthroscopic, and endoscopic procedures.

2. The Relevant Technology

Numerous devices have been developed to eliminate the need to tie knotsas a way of securing a line. The devices that accomplish the samefunction as a knot, which is in part to secure a line to retain tensionin a portion of the line, are typically referred to as line locks.

Line locks generally operate in one of two ways. Some line locks aremanually actuated to secure one or more lines so that tension ismaintained in a portion of the line(s). Once actuated, the line lockresists sliding along the line(s) either toward or away from thetensioned portion of the line. Other line locks are continuouslyadjustable in one direction so that tension is increased in the portionof the line upon which the line lock is advanced. The continuouslyadjustable line locks resist movement away from the tensioned portion ofthe line, but can be further advanced toward the tensioned portion ofthe line with an appropriately applied force.

The portion of a line that is put under tension, typically to securesome object, is commonly referred to as the standing end. The portion ofthe line that extends toward the line handler is commonly referred to asthe working end. A knot in a line, or a line lock attached to a line, isthe demarcation between the standing end and the working end.

Continuously adjustable line locks offer several advantages. They arepassive locking devices, meaning that no other operation is required tosecure the line lock once it is moved along the line to its desiredposition. Furthermore, these line locks can be used to continuouslyincrease the tension in the standing end until it reaches a desiredlevel of tension.

The advantages of line locks over tied knots are very attractive in manyvaried applications, including the use of surgical sutures. However, theline locks developed to date have many deficiencies when considered forsurgical suture applications. For example, many known line locks forsurgical applications are somewhat small, and as a result, they havesmall passageways that are positioned quite close to each other. Thismakes threading the suture through the line lock somewhat difficult.Furthermore, the user must often take special care to thread the suturethrough the line lock in the proper pattern. Use of an improperthreading pattern may cause the line lock to operate improperly, andpossibly, to fail to retain the tissue it is applied to.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present invention will now be discussed withreference to the appended drawings. It is appreciated that thesedrawings depict only typical embodiments of the invention and aretherefore not to be considered limiting of its scope.

FIG. 1 is a perspective view of an adjustable line lock.

FIG. 2 is a top plan view of line lock shown in FIG. 1.

FIG. 3 is an elevated cross sectional side view of the line lock shownin FIG. 1.

FIG. 4A is a perspective view of the line lock shown in FIG. 1 with aline routed therethrough in a slack unlocked position.

FIG. 4B is a perspective view of the line lock shown in FIG. 4A with theline in a tensioned locked position.

FIG. 5 is a top plan view of the line lock shown in FIG. 4B.

FIG. 6 is a bottom plan view of the line lock shown in FIG. 4B.

FIG. 7 is a perspective view of the line lock shown in FIG. 4A with theline routed in a different path.

FIG. 8 is a perspective view of an alternative embodiment of the linelock shown in FIG. 1 with open working passageways.

FIG. 9 is a perspective view of another alternative embodiment of theline lock shown in FIG. 1 with open passageways.

FIG. 10 is a perspective view of another alternative embodiment of theline lock shown in FIG. 1 with dual primary passageways and uniformworking passageways.

FIG. 11 is a perspective view of a line lock for use with a singlestrand of line.

FIG. 12A is a perspective view of the line lock shown in FIG. 11 with aline routed therethrough.

FIG. 12B is a top plan view of the line lock shown in FIG. 12A.

FIG. 12C is a bottom plan view of the line lock shown in FIG. 12A.

FIG. 13A is a top perspective view of a line lock having dual strands ofline routed therethrough.

FIG. 13B is a bottom perspective view of the line lock shown in FIG.13A.

FIG. 14A is a top perspective view of a line lock having a line securedthereto.

FIG. 14B is a bottom perspective view of the line lock shown in FIG.14A.

FIG. 15 is a perspective view of an alternative embodiment of a linelock.

FIG. 16A is a perspective view of the line lock shown in FIG. 15 with aline routed therethrough.

FIG. 16B is a top plan view of the line lock shown in FIG. 16A.

FIG. 16C is a bottom plan view of the line lock shown in FIG. 16A.

FIG. 17 is a perspective view of another alternative embodiment of aline lock.

FIG. 18A is a perspective view of the line lock shown in FIG. 17 with aline routed therethrough.

FIG. 18B is a top plan view of the line lock shown in FIG. 18A.

FIG. 18C is a bottom plan view of the line lock shown in FIG. 18A.

FIG. 19 is a perspective view of a line lock according to anotheralternative embodiment of the invention, with an associated insertiontool.

FIG. 20 is a perspective view of the line lock of FIG. 19, with a suturepassing loosely through the passageways of the line lock.

FIG. 21 is a perspective view of the line lock of FIG. 19, with suturepassing tightly through the passageways of the line lock.

FIG. 22 is a perspective view of a system including a cartridge withthreaders that facilitate the insertion of suture through thepassageways of the line lock of FIG. 19.

FIG. 23 is a perspective view of the system of FIG. 22, with the lid ofthe cartridge open and sutures coupled to the trailing ends of thethreaders.

FIG. 24 is a perspective view of the system of FIG. 22, with thecartridge open and one of the sutures drawn part-way through thecartridge.

FIG. 25 is a perspective view of the system of FIG. 22, with thecartridge open and the sutures fully drawn through the cartridge to passthrough the passageways of the line

FIG. 26 is a perspective view of the system of FIG. 22, with thecartridge open and the sutures and line lock removed from the cartridgefor use.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention relates to line locks that can be used in part toreplace surgical knots tied in sutures in open, arthroscopic, andendoscopic procedures. By increasing the size of the line locks, it isalso appreciated that the line locks can be used outside of surgicalprocedures for any use where it is desired to selectively adjust and/ortie off a line such as a rope, cord, string, or other conventional typeof line.

Depicted in FIG. 1 is one embodiment of a line lock 10 incorporatingfeatures of the present invention. Line lock 10 comprises an elongatedbody 12 having a top surface 14 and an opposing bottom surface 16 thateach extend between a first end 18 and an opposing second end 20. Body12 also has a first side 19 and an opposing second side 21 extendingbetween first end 18 and second end 20. In the embodiment depicted, body12 has a substantially rectangular configuration with rounded ends. Aswill be apparent from the following disclosure, however, body 12 can beany desired configuration such as triangular, circular, square or anyother polygonal or irregular configuration.

In typical surgical applications, body 12 has a maximum dimension Dalong its length (FIG. 2) which is typically less than about 2 cm, morecommonly less than about 1.5 cm, and even more commonly less than about1 cm. Other dimensions can also be used. By way of example and not bylimitation, in one embodiment body 12 has a height in a range betweenabout 1 mm to about 1.5 mm, a width in a range between about 2 mm toabout 3 mm, and length D in a range between about 5 mm to about 8 mm. Innon-surgical applications, body 12 can be any desired dimension. Forexample, maximum dimension D can be in a range from about 5 cm to about0.5 m. Again, other dimensions can also be used.

For use in surgical applications, body 12 can be comprised of anybiocompatible material. The biocompatible material can be bioabsorbableor non-bioabsorbable. Examples of typical materials includenon-bioabsorbable plastic, bioabsorbable plastic, synthetic tissue, andallograft tissue. In non-surgical applications, body 12 can be made ofany desired material such as metal, plastic, wood, fiberglass,composite, or the like.

As depicted in FIG. 1, centrally extending through body 10 between topsurface 14 and bottom surface 16 is a primary passageway 22. As used inthe specification and appended claims, the term “passageway” is broadlyintended to include closed apertures, such as depicted by primarypassageway 22, partially bound apertures, open channels, recesses,grooves, slots, and the like, that are capable of receiving a line andat least partially retaining the line therein. The term “line” as usedin the specification and appended claims is broadly intended to includesuture, cord, rope, filament, wire, cable, and any other form of line.

Extending between surfaces 14 and 16 at first end 18 of body 12 is afirst secondary passageway 24. A second secondary passageway 24′ extendsbetween surfaces 14 and 16 at second end 20. Extending through body 12at a location between primary passageway 22 and first secondarypassageway 24 is a first working passageway 28. In one embodiment,although not necessarily required, first working passageway 28 isdisposed between primary passageway 22 and first secondary passageway 24such that a geometric line segment 36 (FIG. 2) can be extended betweenprimary passageway 22 and first secondary passageway 24 so that linesegment 36 intersects with first working passageway 28. Similar to firstworking passageway 28, a second working passageway 28′ extends throughbody 12 at a location between primary passageway 22 and second secondarypassageway 24′.

Each working passageway 28 and 28′ has an elongated transverse crosssectional area that extends between a first end 38 and an opposingsecond end 40. Each working passageway 28, 28′ comprises an enlargedaccess region 32 at first end 38 which communicates with a constrictedcapture slot 34 at second end 40. Access region 32 is sized to enableeasy feeding of a line into and through the corresponding workingpassageways 28, 28′. Accordingly, although access region 32 can beslightly smaller than the transverse cross sectional area of the linewhich is to be passed therethrough, access region 32 typically has atransverse cross sectional area that is equal to or slightly larger thanthe transverse cross sectional area of the line that is to be passedtherethrough.

In contrast, capture slot 34 has a width W that is substantially equalto or less than the diameter of the line that is to be passed throughworking passageways 28, 28′. For example, in one embodiment width W isless than about 0.9 times the diameter of the line and more commonlyless than about 0.75 times the diameter of the line. It is appreciatedthat working passageways 28, 28′ can come in a variety of differentconfigurations. For example, capture slot 34 can come in a variety ofdifferent constricted, tapered, or notched shaped configurations thatare capable of securely retaining a line through wedged engagement. Forline made of less compressible material, such as metal, the requireddifference between the width W and the diameter of the line may be lessthan the examples given above.

As depicted in FIG. 2, central passageway 22 is bounded by an interiorsurface 42 of body 12 having a substantially triangular transverse crosssection. Interior surface 42 comprises a first side face 44 disposedtoward first working passageway 28, a second side face 46 disposedtoward second working passageway 28′ and which intersects with firstside face 44, and a third side face 48 extending between first side face44 and second side face 46. Although side faces 44 and 46 are shown asbeing substantially flat, in alternative embodiments side faces 44 and46 can be curved or irregular. In one embodiment, however, first sideface 44 is substantially disposed in or tangent to a first planeillustrated by dashed line 50. With reference to FIG. 2, plane 50 slopestoward second end 40 of first working passageway 28 as plane 50 extendsfrom first side 19 of body 12 to second side 21.

First secondary passageway 24 is bounded by an interior surface 54 ofbody 12 having an elongated transverse cross section. Interior surface54 comprises a first side face 56 disposed toward first workingpassageway 28 and an opposing second side face 58. Although side faces56 and 58 are shown as being substantially flat, in alternativeembodiments side faces 56 and 58 can also be curved or irregular. Again,in one embodiment first side face 56 is substantially disposed in ortangent to a second plane illustrated by dashed line 60. With referenceto FIG. 2, second plane 60 slopes toward second end 40 of first workingpassageway 28 as second plane 60 extends from first side 19 of body 12to second side 21.

In the above discussed configuration, first plane 50 and second plane 60are disposed so as to be converging as they extend from first side 19 ofbody 12 to second side 21. In the embodiment depicted, planes 50 and 60intersect at a location 62 on body 12 that is at least substantiallyaligned with a central longitudinal axis of capture slot 34. In otherembodiments, location 62 can be directly adjacent to body 12 or at adistance from body 12. Likewise, location 62 need not be aligned withthe central longitudinal axis of capture slot 34. Although not required,in one embodiment planes 50 and 60 are disposed at equally opposingangles relative to the central longitudinal axis of capture slot 34.Furthermore, planes 50 and 60 can intersect so as to form an insideangle therebetween in a range between about 5° to about 850.

Second secondary passageway 24′ has substantially the same configurationas first secondary passageway 24. Likewise, second secondary passageway24′ has substantially the same relative position to second workingpassageway 28′ and second side face 46 of primary passageway 22 as firstsecondary passageway 26 has to first working passageway 28 and firstside face 44 of primary passageway 22. As such, the discussion withregard to planes 50 and 60 are also applicable to primary passageway 22and second secondary passageway 24′.

By way of example of the passageways and not by limitation, for use witha size USP #2 braided suture, which has a diameter in a range betweenabout 0.5 mm to about 0.6 mm, primary passageway 22 has a length in arange between about 1.3 mm to about 1.5 mm and a width in a rangebetween about 1 mm to about 1.3 mm. Secondary passageways 24 and 24′have a width of about 0.8 mm and a length in a range between 1 mm toabout 1.3 mm. Access region 32 of working passageways 28 and 28′ havewidth in a range between about 0.7 mm to 1 mm while capture slots 17have a width in a range between about 0.3 mm to 0.4 mm.

Depicted in FIG. 3, interior surface 42 of primary passageway 22 extendsto a top outside corner 66 and an opposing bottom outside corner 68. Topoutside corner 66 bounds a top primary opening 70 while bottom outsidecorner 66 bounds a bottom primary opening 72. Similarly, first workingpassageway 28 has an interior surface 74 that extends to a top outsidecorner 76 and an opposing bottom outside corner 78. Top outside corner76 bounds a top working opening 80 while bottom outside corner 76 boundsa bottom working opening 82. Likewise, interior surface 54 of firstsecondary passageway 24 extends to a top outside corner 86 and anopposing bottom outside corner 88. Top outside corner 86 bounds a topsecondary opening 90 while bottom outside corner 86 bounds a bottomsecondary opening 92.

For reasons as will be discussed below in greater detail, each of topoutside corners 66, 76, and 86 has a radius of curvature that is smallerthan the radius of curvature of the corresponding bottom outside corners68, 78, 88. By way of example and not by limitation, in one embodimenttop outside corners 66, 76, and 86 each have a radius of curvature in arange between about 0 mm to about 1 mm with about 0 mm to about 0.5 mmbeing more common. In contrast, bottom outside corners 68, 78, and 88each have a radius of curvature in a range between about 0.25 mm toabout 2 mm with about 0.5 mm to about 1.5 mm being more common. Otherdimensions can also be used, particularly outside of the surgical area.In yet other embodiments it is appreciated that the top outside cornersand the bottom outside corners can have the same radius of curvature orthat only one or more of the top outside corners may be smaller than oneor more of the bottom outside corners. In still other embodiments, it isappreciated that only a portion of one or more of the top outsidecorners may be smaller than a portion of one or more of the bottomoutside corners.

It is again noted that second secondary passageway 24′ and secondworking passageway 28′ having substantially the same configuration asfirst secondary passageway 24 and first working passageway 28,respectively. As such, the same discussion with regard to the outsidecorners are also applicable thereto. Likewise, like elements areidentified by like reference characters.

Depicted in FIG. 4A is a line 100 adjustably mounted on line lock 12.Line 100 comprises a standing portion 102 in the form of a loop whichextends below primary passageway 22, a first working portion 104 whichextends out of first working passageway 28, and a first locking portion106 extending therebetween. It is appreciated that each of the sections102, 104, and 106 of line 100 are relative to each other in that theychange as line 100 is adjusted on line lock 10. Line 100 furtherincludes a second working portion 104′ which extends out of secondworking passageway 28′ and a second locking portion 106′ that extendsbetween standing portion 102 and second working portion 104′.

First locking portion 106 extends up through primary passageway 22, downthrough first secondary passageway 24, and then up through first workingpassageway 28. The section of locking portion 106 extending betweenprimary passageway 22 and first secondary passageway 24 is referred toas compression section 110. Line 100 passes up through first workingpassageway 28 so that first working portion 104 is disposed betweencompression section 110 and capture slot 34. Second locking portion 106′is similarly passed through passageways 22, 24′, and 28′.

During use, standing portion 102 of line 100 is typically looped around,embedded within, or passed through tissue, or some other structure. Tosecure standing portion 102 to the structure, unwanted slack is removedfrom standing portion 102. This is accomplished by sliding line lock 10over standing portion 102 and/or pulling on working portion 104 and/or104′ so that the unwanted slack is pulled through line lock 10. Ineither event, at least one of working portions 104 and 104′ increases inlength while standing portion 102 shortens.

In the configuration depicted in FIG. 4A, line 100 is passing throughenlarged access regions 32 of working passageways 28 and 28′. In thisposition, relative locking portions 106 and 106′ freely slide throughcorresponding passageways of line lock 10 as the unwanted slack fromstanding portion 102 is removed. A mild tension force is typicallyapplied to working portions 104 and 104′ as the unwanted slack isremoved. The applied force pushes compression section 110 and 110′ backtoward first side 19 of body 12 and thus away from capture slots 34,34′. In turn, the portion of line 100 passing through primary passageway22 and secondary passageways 24 and 24′ also naturally slides backwithin the passageways toward first side 19 of body 12. This movement ofline 100 helps to decrease frictional resistance on line 100.

Once the slack is removed from standing portion 102, further force isapplied to working portions 104, 104′ and/or line lock 10 so as totension locking portions 106, 106′ on line lock 10. As depicted in FIG.4B, as line 100 is tensioned, the diverging side face 44 of primarypassageway 22 and side face 56 of first secondary passageway 24 causethe portions of line 100 passing therethrough, and thus compressionportion 110 extending therebetween, to slide toward first side 21 ofbody 12.

Furthermore, as line 100 is tensioned, compression portions 110, 110′are shortened causing them to move into a more linear orientation. As aresult of the above, tensioning of line 100 causes compression portions110, 110′ to force working portions 104, 104′ toward correspondingcapture slots 34, 34′. In turn, at least a portion of line 100 withinworking passageways 28 and 28′ is forced into corresponding captureslots 34, 34′ so that line 100 is secured therein by wedged frictionalengagement. That is, line 100 is secured by compression within captureslots 34, 34′ because line 100 has a diameter larger than the width ofcapture slots 34, 34′. Once line 100 is captured under compression incapture slots 34, 34′, line 100 will remain captured even if there is acomplete loss of tension in standing end 102. Thus, “locking” of linelock 10 to line 100 ensures that line lock 10 will not become separatedfrom line 100, even under cyclic changes in line tension in standing end102. Furthermore, line lock 10 is continuously adjustable in thatfurther tension can be applied to standing portions 104 and/or 104′ atany time to remove additional slack from standing portion 102 whileretaining line 100 locked to line lock 10.

The passageways extending through line lock 10 are also configured suchthat as compression portions 110 and 110′ force line 100 into captureslots 34 and 34′, compression portions 110 and 110′ also fold and/orbias working ends 104 and 104′ over and/or against top outside corner 76of capture slots 34 and 34′. In view of the relatively small radius ofcurvature of top outside corner 76, the engagement between the capturedworking ends 104 and 104′ and top outside corner 76 creates a highdegree of friction which forms a secondary locking mechanism betweenline 100 and line lock 10. As such, the engagement between captureworking ends 104 and 104′ and top outside corner 76 prevents backwardmovement of line lock 10 relative to line 100.

In the embodiment depicted in FIG. 4B, compression portion 110 isdisposed above a portion of top outside corner 76 so as to directly biasworking ends 104 against top outside corner 76. Compression portion 110is also shown disposed directly above a portion of working end 104 thatis biasing against top outside corner 76. In alternative embodiments,compression portion 110 when tensioned can extend between centralpassageway 22 and secondary passageways 24 without passing over workingpassageway 28. That is, compression portion 110 can pass at a locationtoward second side 21 of line lock 10 that is spaced apart from workingpassageway 28. In this embodiment, compression portion 110 still passesover working end 104, thereby remotely causing working end 104 to foldover and bias against top outside corner 76.

One of the unique features of the present embodiment is that as linelock 10 is advanced toward standing end 102 when standing end 102 is notunder tension, i.e., when slack is being removed from standing end 102,working ends 104 and 104′ tend to push away compression portions 110 and110′, as discussed above, thereby minimizing frictional engagementbetween working ends 104, 104′, compression portions 110, 110′ and linelock 10. As a result, line lock 10 can be easily advanced on line 100.

Furthermore, unlike some other continuously adjustable line locks knownin the art that use a loop portion to draw in and wedge a portion of aline within a bore hole, compression portions 110 and 110′ traverse asubstantially straight path because they are constrained by secondarypassageways 24 and 24′ and primary passageway 22. This substantiallystraight path translates to a lower frictional resistance to sliding notpossible with other adjustable line locks known in the art.

As previously discussed, line 100 is routed through passageways 22, 24,and 28 so as to pass over the outside corners of the passageways. When atensioned section of line 100 passes around a first outside corner ofline lock 10, friction produced between line 100 and the correspondingoutside corner cause a decrease in tension on the portion of line 100extending away from the outside corner on the side opposite thetensioned section. The friction produced at the outside corner must beovercome in order to cause line 100 to slide. Similarly, as the linepasses around subsequent outside corners away from the tensionedsection, each subsequent corner produces an incremental decrease in linetension and a corresponding incremental increase in friction that mustbe overcome to cause line 100 to slide. The loss in tension and increasein friction diminishes for each subsequent corner. Thus, the firstcorners are the most significant.

As depicted in FIG. 6, in view of the above discussion, when working end104 is tensioned and standing end 102 is slack, line 100 extending fromworking end 104 toward line lock 10 first turns on bottom outside corner78 of working passageway 28 and bottom outside corner 88 of secondarypassageway 24. As a result of the fact that these are the closestoutside corners to tensioned working end 104, outside corners 78 and 88will produce the highest frictional resistance. Accordingly, to minimizethe frictional resistance produced by outside corners 78 and 88 andthereby ease the sliding of line lock 10 toward standing end 102,outside corners 78 and 88 are generously rounded as previouslydiscussed.

In contrast, as depicted in FIG. 5, when standing end 102 is tensionedand working end 104 is slack, line 100 extending from standing end 102toward line lock 10 first turns on top outside corner 66 of primarypassageway 22 and top outside corner 86 of secondary passageway 24. Inview of the fact that these are the closest outside corners to tensionedstanding end 102, outside corners 66 and 86 will produce the highestfrictional resistance. Accordingly, to maximize the frictionalresistance produced by outside corners 66 and 86 and thereby minimizingslipping of line 100 once tensioned, outside corners 66 and 86 areformed relative sharp as previously discussed. More specifically, topoutside corners 66 and 86 have a smaller radius of curvature than bottomoutside corners 78 and 88. It is noted that not all of each outsidecorner that bounds a corresponding opening has to have the same radiusof curvature. For example, the portion of each outside corner thatdirectly engages line 100 can have a radius of curvature that isdifferent from the remainder of the corresponding outside corner.

Depicted in FIG. 7, line lock 10 is shown having an alternative routingof line 100. To achieve this routing, working ends 104 and 104′ arepassed up through secondary passageways 24 and 24′, respectively, downthrough primary passageway 22, and then back up through workingpassageways 28 and 28′, respectively. Again compression portions 110 and110′ are formed that selectively force working ends 104 and 104′ towardcapture slots 34 as discussed above. In yet another alternative, it isappreciated that one end of line 100 can be routed as shown in FIG. 4Awhile the opposing end of line 100 is routed as shown in FIG. 7.

Depicted in FIG. 8 is an alternative embodiment of a line lock 120. Itis noted that all common elements of alternative embodiments of linelocks disclosed herein are identified by like reference characters. Linelock 120 comprises body 12 having primary passageway 22 and secondarypassageways 24 and 24′ extending therethrough as discussed above withregard to FIG. 1. In contrast to the circumferentially closed workingpassageways 28, 28′, however, line lock 120 comprises workingpassageways 122 and 122′ that are circumferentially open. That is, eachworking passageway 122 and 122′ comprises an elongated tapered slothaving a first end 124 and an opposing second end 126. First end 124 isopen along first side 19 of body 12 to facilitate convenient loading ofline 100 therein. First end 124 also typically has a width greater thanthe diameter of line 100. Second end 126 extends to a location betweenprimary passageway 22 and a corresponding one of secondary passageway24, 24′.

In this embodiment it is noted that the passageways are positioned suchthat a geometric line segment 130 can be extended between primarypassageway 22 and secondary passageway 24′ such that line segment 130does not intersect with working passageway 122′. However, a geometricline segment 132 can also be extended between primary passageway 22 andsecondary passageway 24′ such that line segment 132 intersects withworking passageway 122′. Second end 126 of each working passageway 122,122′ typically has a width substantially equal to or smaller than thediameter of line 100.

Depicted in FIG. 9 is another alternative embodiment of a line lock 136having substantially the same configuration as line lock 120. Incontrast to the circumferentially bounded primary passageway 22 andsecondary passageways 24 and 24′ of line lock 120 in FIG. 8, however,line lock 136 comprises a partially bounded primary passageway 138 whichis open at second side 21 of body 12 and partially bounded secondarypassageways 140 and 140′ that are also each open at or adjacent tosecond side 21 of body 12.

Two separate locking features were previously discussed with regard tosecuring line 100 to line lock 10. Specifically, line 100 is secured bybeing wedged into capture slots 34 and 34′ and by biasing workingportions 104 and 104′ against the top outside corner 76 of each workingpassageway 28, 28′. In alternative embodiments, it is appreciated thatthe locking features can be used independently. For example, depicted inFIG. 10 is a line lock 144 having body 12 with secondary passageways 24and 24′. In contrast to line lock 10, however, line lock 144 comprisesworking passageways 146 and 146′ wherein capture slots 34 have beeneliminated. Working passageways 146 and 146′ merely comprise elongatedchannels having a width substantially the same size or larger than thediameter of the line 100 to be passed therethrough. Line 100 is thusprimarily secured to line lock 144 as a result of compression portions110, 110′ biasing line 100 against top outside corner 76 of each workingpassageways 146 and 146′ as previously discussed.

Line lock 144 is also distinguished over line lock 10 in that primarypassageway 22 has been replaced with a first primary passageway 148 anda spaced apart second primary passageway 148′. Primary passageways 148and 148′ operate with opposing ends of line 100. It is also noted thatin alternative embodiments primary passageway(s) and/or the secondarypassageways need not be elongated to allow the line passing therethroughto slide toward opposing sides 19 and 21 of body 12 as previouslydiscussed with regard to line lock 10.

Depicted in FIG. 11 is an alternative embodiment of a line lock 150 thatis designed to slide along a single strand of line 100. Line lock 150comprises a substantially disk shaped body 152 having a top surface 154and an opposing bottom surface 156. Extending through body 152 betweensurfaces 154 and 156 is a primary passageway 158 and a spaced apartsecondary passageway 160. Disposed between passageways 158 and 160 is aworking passageway 162. Similar to line lock 10, working passageway 162of line lock 150 has a first end with enlarged access region 32 and anopposing second end with constricted capture slot 34 thereat.

Primary passageway 158 and secondary passageway 160 have substantiallythe same elongated circular configuration which is similar to previouslydiscussed secondary passageway 24. Each of passageways 158 and 160 hasan inside face 162 and 164, respectively, that is disposed towardworking passageway 162. Each inside face 162 and 164 is substantiallydisposed in or is tangent to a corresponding plane 168 and 170,respectively. Planes 168 and 170 converge toward capture slot 34 ofworking passageway 162 and diverge away from access region 32.

Also extending through body 152 between top surface 154 and bottomsurface 156 is an end passageway 172. Although end passageway 172 can bepositioned at a variety of different locations, end passageway 172 isshown aligned with working passageway 162 such that a plane extendingbetween working passageway 162 and end passageway 172 separates primarypassageway 158 from secondary passageway 160.

During use, as depicted in FIGS. 12A-12C, line 100 is routed throughline lock 150 by passing working portion 104 from top surface 154 tobottom surface 156 through end passageway 172, up through primarypassageway 158, down through secondary passageway 160, and finally upthrough working passageway 162. Compression portion 110 of line 100extends between primary passageway 158 and secondary passageway 160 andis positioned to act upon working portion 104. Line lock 150 can beselectively advanced by pulling working portion 104 away from topsurface 154 so that line 100 travels through line lock 150.Alternatively, line lock 150 can be manually slid toward standingportion 102. In either event, the length of standing portion 102 isdecreased.

As line 100 is tensioned on line lock 150, line 100 locks on line lock150 in substantially the same manner that line 100 locks with workingpassageway 28 as previously discussed with regard to line lock 10. Thatis, compression portion 110 forces working end 104 toward capture slot34 so that the portion of line 100 within working passageway 162 iscaptured by wedged frictional engagement within capture slot 34.Furthermore, compression portion 110 either directly or indirectlybiases working portion 104 against the top outside corner 76 of workingpassageway 162 at the second end thereof so as to increase thefrictional engagement between line 100 and line lock 150. Line lock 150thus provides a continuously adjustable line lock or a one way slidingstop. In alternative embodiments, it is appreciated that line lock 150can be modified in at least the same ways as discussed with the otherline locks disclosed herein.

The embodiment shown in FIGS. 12A-12C is advantageous in certainapplications where line lock 150 is positioned behind a first object andworking portion 104 and standing portion 102 pass through the firstobject. In this situation, standing portion 102 is fixed to a secondobject. By pulling on working portion 104, the first object is drawnirreversibly toward the second object. This is an advantage withsurgical sutures where standing end 102 of a suture is attached tonormal tissues and line lock 150 is placed behind tissue that has tornaway. Standing portion 102 and working portion 104 pass through the torntissue toward the normal tissue. By pulling on working portion 104 ofsuture, the torn tissue is pulled into apposition with the normaltissues and line lock 150 maintains the torn tissue adjacent to thenormal tissue to facilitate healing of the tissue.

Depicted in FIGS. 13A and 13B is another embodiment of a line lock 180incorporating features of the present invention. Line lock 180 alsocomprises a substantially disk shaped body 182 having a top surface 184and an opposing bottom surface 186. As with line lock 150, line lock 180includes primary passageway 158, secondary passageway 160, and workingpassageway 162. Again, although not required, working passageway 162 isdisposed such that a geometric line segment can be extended betweenprimary passageway 158 and secondary passageway 160 so that the linesegment intersects with working passageway 162. In contrast to line lock150, line lock 180 does not include end passageway 172.

Each of passageways 158, 160, and 162 is configured to receive a doublestrand of line 100. Specifically, during use both working end 104 and104′ are passed up through primary passageway 158, down throughsecondary passageway 160 and then back up through working passageway162. As a result, standing portion 102 is again formed in a loop thatcan be looped around, passed through, or otherwise secured to tissue orother structure. Unwanted slack is removed from standing portion 102 byagain sliding line lock 180 on line 100 toward standing portion 102and/or by pulling on one or both of working portions 104 and 104′ sothat line 100 passes through line lock 180.

When line 100 is tensioned on line lock 180, compression portions 110and 110′ force working portions 104, 104′ toward capture slot 34 so thata portion of each line section passing through working passageway 162 iscaptured by wedged frictional engagement within capture slot 34.Compression portions 110 and 110′ also bias working portions 104 and104′ toward and/or against top outsider corner 76 of working passageway162 so as to increase the frictional engagement between line 100 andline lock 180. As previously discussed with passageways 22, 24, and 28of line lock 10 in FIGS. 1-6, the radius of curvature of the top outsidecorner and bottom outside corner of each passageway 158, 160, and 162can be set so as to further control the ability of line 100 to slide ornot slide through the passageway. Other alternatives as discussed withthe line locks herein are also applicable to line lock 180. Inparticular each of the passageways 158, 160, and 162 can also beconfigured to receive a single strand of line 100. In this configurationthe single strand of line 100 is routed in a manner as described abovefor the double strand of line 100. Instead of the standing portion 102forming a loop when a double strand of line 100 is used, in this casethe standing portion 102 consists of a free end which can be attached totissue or other structures.

Depicted in FIGS. 14A and 14B is still another embodiment of a line lock190 incorporating features of the present invention. Line lock 190 hassubstantially the same configuration as line lock 180 with like elementsbeing referenced with like reference characters. The primary distinctionbetween line locks 180 and 190 is that in line lock 190, an end 192 ofline 100 adjacent to standing portion 102 is secured to bottom surface186 of body 182. End 192 can be secured to body 182 by being integrallymolded into body 182 or can be otherwise secured such as by welding ormechanical attachment.

Line lock 190 is also distinguished from line lock 180 in thatpassageways 158, 160, and 162 need only be configured to receive asingle strand of line 100. That is, working end 104 passes up throughprimary passageway 158, down through secondary passageway 160, and thenback up through working passageway 162. Standing portion 102 is againsubstantially formed into a loop extending from end 192 of line 100 toprimary passageway 158. Because end 192 of line 100 is secured to body182, unwanted slack can be removed from standing portion 102 by pullingline 100 through line lock 190 and/or sliding line lock 190 down line100. Line 100 is locked to line lock 190 in substantially the samemanner as discussed above with regard to the other line locks when line100 is tensioned on line lock 190.

Depicted in FIG. 15 is still another embodiment of a line lock 200incorporating features of the present invention. Line lock 200 comprisesan elongated substantially box shaped body 202 comprising a top wall 204and an opposing bottom wall 206 each extending between a first side wall208 and a first end 210 and an opposing second side wall 212 and anopposing second end 214. Also extending between top wall 204 and bottomwall 206 is a front wall 216 and an opposing back wall 218.

Partially bounded within body 202 is a hollow chamber 220. An accesschannel 222 is formed on front wall 216 so as to communicate withchamber 220. Also communicating with chamber 220 is a primary passageway224. Primary passageway centrally extends through bottom wall 206 tochamber 220. A first secondary passageway 226 extends through first sidewall 208 so as to communicate with chamber 220 while a second secondarypassageway 226′ extends through second side wall 212 so as tocommunicate with chamber 220. A pair of first working passageways 228and 228′ extend through bottom wall 206 and top wall 204, respectively,in vertical alignment between primary passageway 224 and first secondarypassageway 226.

Similarly, a pair of second working passageways 230 and 230′ extendthrough bottom wall 206 and top wall 204 in vertical alignment betweenprimary passageway 224 and second secondary passageway 226′. As with theprior working passageways, each of working passageways 228, 228′ and230, 230′ has a first end towards front wall 226 with an enlarged axisregion 32 and an opposing second end toward back wall 218 with a captureslot 34 formed thereat.

During use, as depicted in FIG. 16A-16C, working portions 104 of line100 are passed up through primary passageway 224 into chamber 220.Working portion 104 then passes out of chamber 220 through firstsecondary passageway 226. Finally, working portion 104 passes up throughfirst working passageway 228, through chamber 220, and then out throughfirst working passageway 228′. Compression portion 110 of line 100extends from primary passageway 224 to first secondary passageway 226.Working portion 104 is routed such that line 100 passes betweencompression portion 110 and back wall 218.

In like manner, working portion 104′ extends from chamber 220 outthrough second secondary passageway 226′. Working portion 104′ thenextends up through second working passageway 230, through chamber 220,and then out through second working passageway 230′. Again, line 100extends between compression portion 110′ and back wall 218.

As with the other embodiments, line lock 200 can be slid along line 100and/or line 100 can be pulled therethrough so as to remove all unwantedslack from standing portion 102. As line 100 is tension on line lock200, compression portions 110 and 110′ force the portion of line 100extending between first working passageways 228 and 228′ and betweensecond working passageways 230 and 230′, respectively, towardcorresponding capture slots 34. As a result, at least a portion of line100 extending through each of the working passageways is captured byfrictional wedge engagement within each of the corresponding captureslots 34. Line 100 is thus locked with line lock 200.

Line lock 200 offers several advantages. When standing end 102 is slackand working ends 104 and 104′ are tensioned, the sections of line 100extending between working passageways 228 and 228′ and between workingpassageways 230 and 230′ force compression portions 110 and 110′,respectively, back toward front wall 216 so as to allow the free travelof line 100 through line lock 200. In contrast, as discussed above, whentension is created in standing end 102 and slack is created in workingends 104 and 104′, compression portions 110 and 110′ force the sectionsof line 100 extending between working passageways 228 and 228′ andbetween working passageways 230 and 230′ toward back wall 218 so as tosecure line 100 within the capture slots 34. This back and forthmovement of compression portions 110 and 110′ creates “backlash,” or afinite distance that line lock 200 can move away from standing end 102until locking of line 100 is achieved.

Top wall 204 of line lock 200 provides a physical constraint to theamount of movement seen in compression portions 110 and 110′, therebyminimizing the amount of backlash. Furthermore, top wall 204 provides anadditional friction point when compression portions 110 and 110′compress against line 100, thereby increasing the strength of thelocking of line 100. That is, one friction point is located at workingpassageways 228 and 230 on bottom wall 206 and the second friction pointis located at working passageways 228′ and 230′ on top wall 204.

It is again appreciated that the alternatives as discussed with theother embodiments are also applicable to line lock 200. By way ofexample and not by limitation, line 100 can be routed through line lock200 in a manner analogous to the routing in FIG. 7. The variouspassageways can be open or closed as depicted in FIGS. 8 and 9.Similarly, line lock 200 can be divided in half and modified to functionsimilar to the line locks shown in FIGS. 11-14.

Depicted in FIG. 17 is a final alternative embodiment of a line lock 240incorporating features of the present invention. Line lock 240 has aconfiguration similar to line lock 200 and thus like elements areidentified by like reference characters. Line lock 240 comprises anelongated substantially box shaped body 242. Similar to line lock 200,body 242 comprises top wall 204 and bottom wall 206 extending betweenside wall 208 and side wall 212. Body 242 also includes front wall 216and back wall 218 which partially bound chamber 220.

In contrast to line lock 200, a first primary passageway 241 extendsthrough first side wall 208 while second primary passageway 241′ extendsthrough second side wall 212. Primary passageways 241 and 241′ eachcommunicate with chamber 220. Body 242 of line lock 240 furthercomprises a first secondary passageway 244 extending through back wall218 in communication with chamber 220 and a spaced apart secondsecondary passageway 244′ in communication with chamber 220. A firstaccess port 246 extends through front wall 216 in alignment with firstsecondary passageway 244′ so as to communicate with chamber 220.Similarly, a second access port 246′ extends through front wall 216 inalignment with second secondary passageway 244 so as to also communicatewith chamber 220.

Furthermore, in contrast to the bounded working passageways of line lock200, line lock 240 comprises a pair of first working passageways 248 and248′. Working passageway 248 comprises a constricting slot that isformed on bottom wall 206 and is open along intersecting front wall 216.First working passageway 248′ is aligned with first working passageway248 and is formed on top wall 204 so as to also be open alongintersecting front wall 216. A pair of second working passageways 250and 250′ are similarly formed on bottom wall 206 and top wall 204 so asto be aligned with second secondary passageway 244′. Each of the workingpassageways terminates at capture slot having a width substantiallyequal to or smaller than the diameter of line 100.

During use, as depicted in FIGS. 18A-18C, working end 104 of line 100 ispassed through first primary passageway 242 into chamber 220 and thenout through first secondary passageway 244. Working end 104 then passesdown around bottom wall 206 and is then fed up through first workingpassageways 248 and 248′. A compression portion 110 of line 100 extendsbetween primary passageway 241 and secondary passageway 244. Workingportion 104 is passed between working passageways 248, 248′ so that line100 passes between compression portion 110 and first secondarypassageway 244.

Working portion 104′ is similarly passed through the passageways on theopposing side of line lock 240. That is, working portion 104′ passesthrough primary passageway 241′ and into chamber 220. Working portion104′ then travels out through secondary passageway 244′, bends aroundbottom wall 206, and then travels up through working passageways 250 and250′.

In the above configuration, slack can be removed from standing portion102 by pulling line 100 through line lock 240 and/or sliding line lock240 toward standing portion 102. As line 100 tensions on line lock 240,compression portions 110 and 110′ again force portions of line 100 intocapture slots 34 of the working passageways so as to secure line 100 toline lock 240 by wedged frictional engagement.

Like line lock 200, line lock 240 provides containment of compressionportions 110 and 110′ to minimize backlash. Unlike the otherembodiments, line 100 is routed through line lock 240 such that at leastone line turn exceeds 90 degrees. For example, the transition betweencompression portions 110 and 110′ and looping portions, designated as252 and 252′, respectively, create 180 degree turns in line 100. Thesesharp bends in line 100 increase the friction that must be overcome inorder to advance line lock 240 toward standing end 102. However, thesharp bends also contribute to greater locking strength of line lock 240to line 100. This embodiment is beneficial when line 100 is monofilamentor single strand line, due to the commonly lower line on line frictionand greater flexural stiffness of monofilament line when compared tobraided or twisted strand line.

Referring to FIG. 19, a perspective view illustrates a line lock 310according to one alternative embodiment of the invention. As shown, theline lock 310 has a body 312 that is generally disc-shaped. The body 312has a top surface 314, a bottom surface 316, and a periphery 318 thatextends between the top surface 314 and the bottom surface 314 to definea generally circular profile. In this application, a shape having a“generally circular profile” is any shape in which the outside boundaryof any cross section passing through the main portion of the shape issubstantially circular.

The body 312 bounds a plurality of passageways designed to cooperatereceive a line such as a suture. In this application, passageways that“cooperate to receive” a line such as a suture receive the line suchthat the line passes through all of the cooperating passageways. Thepassageways of the body 312 include a first primary passageway 322 and asecond primary passageway 323, each of which may be positioned adjacentto the periphery 318. The primary passageways 322, 323 are positioned onopposite sides of the body 312.

Furthermore, in the line lock 310 of FIG. 19, the passageways include afirst secondary passageway 324 and a second secondary passageway 325,which are also positioned on opposite sides of the body 312, adjacent tothe periphery 318. The secondary passageways 324, 325 may be positionedslightly closer to the periphery 318 than the primary passageways 322,323. Yet further, the passageways also include a first workingpassageway 328 and a second working passageway 329. The workingpassageways 328, 329 are relatively centrally located with respect tothe body 312.

Each of the primary and secondary passageways 322, 323, 324, 325 may begenerally rounded, and may optionally be somewhat elongated to providean oval cross-section capable of receiving a doubled-over suture end, aswhen a suture end (not shown) is inserted through a loop (not shown) anddrawn through the primary and secondary passageways 322, 323, 324, 325via the loop. Each of the working passageways 328, 329 may also have across-section broad enough to receive a doubled-over suture end.

The passageways 322, 323, 324, 325, 328, 329 intersect the top surface314 to form corresponding openings, each of which is bounded by one of aplurality of top outside corners 336. The passageways 322, 323, 324,324, 328, 329 also intersect the bottom surface 316 to formcorresponding openings, each of which is bounded by one of a pluralityof bottom outside corners (not shown).

As in the description previously set forth, some or all of the topoutside corners 336 may have a smaller (i.e., sharper) radius than thecorresponding bottom outside corners. More particularly, the top outsidecorners 336 of the working passageways 328, 329 may have comparativelysmall radii when compared to the bottom outside corners. In fact, in theembodiment of FIG. 19, the radii of the top outside corners 336 of theworking passageways 328, 329 are considerably sharper than those of thetop outside corners 336 of the primary and secondary passageways 322,323, 324, 325. The sharp radii of the top outside corners 336 of theworking passageways 328, 329 enhances locking of the suture by the linelock 310.

Each of the working passageways 328, 329 may have a shape that alsofacilitates locking of the suture, such as the teardrop-shapedcross-section illustrated in FIG. 19. More precisely, each of theworking passageways 328 may have an access region 332 and a capture slot334. The access region 332 is large enough to permit the suture to passtherethrough with clearance. However, the capture slot 334 may besomewhat narrower such that, when the suture is drawn into the captureslot 334, the walls of the capture slot 334 press against the suture torestrict further motion of the suture through the slot 334. Theoperation of the capture slot 334 will be further shown and described inconnection with FIGS. 20 and 21.

In the embodiment of FIG. 19, the first primary, secondary, and workingpassageways 322, 324, 328 are symmetrically arranged about the center ofthe body 312 with respect to the second primary, secondary, and workingpassageways 323, 325, 329. In other words, the first primary, secondary,and working passageways 322, 324, 328 possess radial symmetry withrespect to the second primary, secondary, and working passageways 323,325, 329. Accordingly, if the first primary, secondary, and workingpassageways 322, 324, 328 were rotated 180° about a central axis 338 ofthe body 1212, they would be substantially superimposed on the secondprimary, secondary, and working passageways 323, 325, 329.

According to one alternative embodiment, the capture slots 334 mayextend at angles with respect to the access regions 332 so that theworking passageways 328, 329 may be more compactly arranged, whilekeeping the capture slots 334 at the desired position and orientationwith respect to the first primary and secondary passageways 322, 324 andwith respect to the second primary and secondary passageways 323, 325.Such a configuration may potentially provide a more compact line lock(not shown) without losing suture locking capability.

In addition to the line lock 310, FIG. 19 also illustrates an insertiontool 340 that may be used to insert a line lock such as the line lock310 of FIG. 19 into a relatively constricted space, such as a spacewithin the body accessed via a cannula or the like. The insertion tool340 has a proximal end (not shown), which may have handle or otherstructure to facilitate grasping by hand. The insertion tool 340 alsohas a distal end 342 and a hollow bore 344 that may extend along theentire displacement between the proximal end and the distal end 342 sothat sutures or other items can be inserted into one end of the hollowbore 344 and retrieved from the opposite end. The distal end 342 has arim 346, which may have an annular shape, a frustoconical shape, or thelike, such that the body 312 is able to seat against the rim 346. Theinsertion tool 340 can thus be used to advance the line lock 310 in amanner that will be more fully set forth in the description of FIG. 20.

Referring to FIG. 20, a perspective view illustrates a system 348including the line lock 310 of FIG. 19 and a suture 350 relativelyloosely passing through the passageways 322, 323, 324, 325, 328, 329 ofthe body 312. The suture 350 may be similar or identical to thatdescribed previously. Accordingly, the suture 350 may have a standingportion 352, which is the portion of the suture 350 that is placed undertension and constrained by advancement of the line lock 310, first andsecond working portions 354, 355, which are handled by a user, and firstand second locking portions 356, 357 that are positioned between thestanding portion 352 and the first and second working portions 354, 355,respectively.

The suture 350 may be inserted through the passageways 322, 323, 324,325, 328, 329 according to a wide variety of methods. For example, thesuture 350 may be inserted by hand. Alternatively, the suture 350 may beinserted through the use of threaders (not shown) that are initiallyrouted through the passageways 322, 323, 324, 325, 328, 329 along theproper pathways. The threaders may have leading ends designed to bedrawn by hand, and trailing ends with loops or other features capable ofcapturing and drawing the suture ends, as will be shown and described inconnection with FIGS. 22-26. In addition to or in the alternative to theuse of threaders, a cartridge (not shown) may be used to retain the linelock 310 and guide the suture 350 through the passageways 322, 323, 324,325, 328, 329 along the desired pathways, as will also be shown anddescribed subsequently.

As illustrated in FIG. 20, the first locking portion 356 extends fromthe standing portion 352 through the first primary passageway 322, thenthrough the first secondary passageway 324, and then through the firstworking passageway 328. From the first working passageway 328, the firstworking portion 354 extends between the top surface 314 and the sectionof the first locking portion 356 that passes from the first primarypassageway 322 to the first secondary passageway 324. This section ofthe first locking portion 356 is a first compression section 360 of thesuture 350.

Similarly, the second locking portion 357 extends from the standingportion 352 through the second primary passageway 323, then through thesecond secondary passageway 325, and then through the second workingpassageway 329. From the second working passageway 329, the secondworking portion 355 extends between the top surface 314 and the sectionof the second locking portion 357 that passes from the second primarypassageway 323 to the second secondary passageway 325. This section ofthe second locking portion 357 is a second compression section 361 ofthe suture 350.

The standing portion 352 may be inserted through and/or around somefeature (not shown), such as bodily tissue, that is to be retained bythe system 348. The standing portion 352 may additionally oralternatively pass through an opening of a bone anchor or the like toenable tissues to be anchored to the bone, as in rotator cuff repair.From the configuration of FIG. 20, the suture 350 may be tightened byadvancing the line lock 310 along the standing portion 352. The linelock 310 may be advanced by holding the working portions 354, 355 andpressing the body 312 toward the standing portion 352.

According to one method, the line lock 310 may be advanced along thestanding portion 352 through the use of a tool such as the insertiontool 340 of FIG. 19. More precisely, the working portions 354, 355 mayfirst be inserted into the hollow bore 344 at the distal end 342. Theworking portions 354, 355 are inserted through the hollow bore 344 suchthat they protrude from the hollow bore 344 at the proximal end. A usermay then grasp the working portions 354, 355 and draw them proximally,while holding the insertion tool stationary or advancing it distally,until there remains no slack in the working portions 354, 355, and thebody 312 is seated against the rim 346 of the distal end 342. The shapeof the rim 346 may tend to draw the body 312 into a position andorientation coaxial with the insertion tool 340 to facilitate insertionof the line lock 310 into a relatively narrow space.

Once the slack has been removed from the working portions 354, 355,further tension on the working portions 354, 355 tends to cause thelocking portions 356, 357 to advance through the passageways 322, 323,324, 325, 328, 329, moving from the primary passageways 322, 323 towardthe working passageways 328, 329. Motion of the locking portions 356,357 in this direction is relatively unrestricted since the compressionsections 360, 361 remain slack, thereby allowing the locking portions356, 357 to move through the access regions 332 of the workingpassageways 328, 329. Consequently, the line lock 310 is able to advancealong the standing portion 352, thereby causing the standing portion 352to tighten.

In alternative to use of a tool such as the insertion tool 340 of FIG.19, the line lock 310 may be advanced along the standing portion 352without any tooling. For example, the line lock 310 may be pressed andmoved along the standing portion 352 by direct pressure from a finger.Alternatively, grasping the working portions 354, 355 and pulling themin substantially opposite and/or co-linear directions may cause the linelock 310 to advance along the standing portion 352. Each of the workingportions 354, 355 may then lie along the top surface 314, but may notpass through the corresponding capture slot 334 until locking isperformed. Such a technique may be particularly useful for retainingtissues in more readily accessible areas, where the working portions354, 355 can be oriented and drawn in opposite directions. Use ofinsertion tooling may be more appropriate for more confined spaces.

Referring to FIG. 21, a perspective view illustrates the system 348 ofFIG. 20, with the suture 350 routed relatively tightly through thepassageways 322, 323, 324, 325, 328, 329. As the standing portion 352tightens, tension in the standing portion 352 causes the compressionsections 360, 361 to become taught. The compression sections 360, 361straighten, thereby drawing the portions of the suture 350 within theworking passageways 328, 329 outward, into the capture slots 334. Thesections of the working portions 354, 355 adjacent to the workingpassageways 328, 329 are pinned against the top surface 314 by thecompression sections 360, 361.

Accordingly, each of the working portions 354, 355 is bent twice, witheach bend having an angle of about ninety degrees. A first bend 370 isabout the top outside corner 336 of each corresponding workingpassageway 328, 329, and a second bend 372 is about the correspondingcompression section 360, 361. As mentioned previously, the top outsidecorners 336 of the working passageways 328, 329 have tight radii.Accordingly, the top outside corners 336 of the working passageways 328,329 provide relatively high friction surfaces, particularly when theworking portions 354, 355 are pressed against them via tension, likethat applied by the compression sections 360, 361. The compressionsections 360, 361 may also provide considerable friction, depending onthe structure and material of the suture 350.

Due to the friction applied to the bends 370, 372 of each of the workingportions 354, 355 by the tensioned standing portion 352, the workingportions 354, 355 are generally unable to retract back into the workingpassageways 328, 329. However, the standing portion 352 may still betightened by further drawing on the working portions 354, 355. Tensionin the working portions 354, 355 tends to pull the compression sections360, 361 inward, thereby removing the bends 370, 372 and relieving theassociated sources of friction. Further advancement of the body 312along the standing portion 352 only increases the level of tension inthe standing portion 352 so that, when tension on the working portions328, 329 is relieved, the working portions 328, 329 are again drawn tothe locked configuration.

After the locking portions 356, 357 have been locked via tension in thestanding portion 352, the working portions 354, 355 may be cut short,for example, just outside the second bends 372. The friction on thebends 370, 372 keeps slippage to a level low enough that cutting theworking portions 354, 355 in such a manner does not impair the operationof the line lock 310. The second bends 372 may disappear because thereis no longer tension drawing the working portions 354, 355 to theorientation illustrated in FIG. 21. However, the second bends 372 arenot required for locking; rather, the compression sections 360, 361continue to press the suture 352 against the top surface 314, adjacentto the first bends 370. The friction of this compression interface, inaddition to that of the first bends 370, is sufficient to keep thesuture 350 from slipping back through the passageways 322, 323, 324,325, 328, 329.

If desired, the line lock 310 and/or the suture 352 may be formed ofbiodegradable or bioabsorbable materials. Alternatively, the line lock310 and the suture 352 may be small and compact enough that they canremain in the body indefinitely without causing any discomfort orsignificant health risks.

Referring to FIG. 22, a perspective view illustrates one embodiment of asystem 400 including the line lock 310 of the previous embodiment (notvisible in FIG. 22), and various implements to help insert, or “thread,”the suture 350 through the passageways 322, 323, 324, 325, 328, 329 ofthe line lock 310. A longitudinal direction 402, a lateral direction404, and a transverse direction 406 cooperate to form a system oforthogonal axes that will be used for reference in the followingdescription.

In addition to the line lock 310, the system 400 includes a cartridge410, a first threader 412, and a second threader 414. The cartridge 410contains the line lock 310 and, when in the closed configuration shownin FIG. 22, substantially encloses the line lock 310 to facilitateinsertion of the suture 350 through the passageways 322, 323, 324, 325,328, 329, and possibly, to help isolate the line lock 310 fromcontaminants. In this application, the phrase “substantially enclose”does not require full enclosure; rather, some portion(s) of thesubstantially enclosed part may protrude from the enclosure.

The cartridge 410 may be formed of a plastic such as polypropylene,PEEK, or the like. The threaders 412, 414 pass through the cartridge 410along first and second pathways, respectively, to enable a user to drawthe suture 350 through the passageways 322, 323, 324, 325, 328, 329along the correct pattern, as will be described in greater detailsubsequently. The threaders 412, 414 may be formed substantially of afibrous material or a plastic, such as nylon.

As shown in FIG. 22, the cartridge 410 has a first longitudinal end 420,a second longitudinal end 422, a first lateral end 424, and a secondlateral end 426. The threaders 412, 414 pass through the longitudinalends 420, 422. Furthermore, the cartridge 410 has a lid 430 designed tomove with respect to the remainder of the cartridge 410, which will bereferred to as a containment portion 432. More specifically, a livinghinge 434 extends generally along the first lateral end 424, between theadjacent edges of the lid 430 and the containment portion 432. Theliving hinge 434 is integrally formed with the lid 430 and thecontainment portion 432 and flexes to enable pivotal motion of the lid430 with respect to the containment portion 432. In alternativeembodiments, a conventional hinge may be used, or a lid may be slidablewith respect to and/or fully removable from the remainder of thecartridge, thereby obviating the need for a hinging mechanism.

A first tab 436 integrally formed with the lid 430 and a second tab 438integrally formed with the containment portion 432 may easily be pushedin opposite directions, for example, by a user's thumbs, to open thecartridge 410. The lid 430 and the containment portion 432 may bedesigned to adhere to each other at the second lateral end 426 so thatthe cartridge 410 only opens when a threshold force is applied. Thus,the cartridge 410 may not open if dropped or jostled.

The first longitudinal end 420 has a first set of slots 440 throughwhich the threaders 412, 414 pass. Similarly, the second longitudinalend 422 has a second set of slots 442 through which the threaders 412,414 pass. Thus, the threaders 412, 414 extend into the cartridge 410through the first longitudinal end 420 and out again through the secondlongitudinal end 422. Each of the threaders 412, 414 has a leading end450 adjacent to the second set of slots 442 and a trailing end 452adjacent to the first set of slots 440.

Each of the leading ends 450 has a pull feature designed to facilitategrasping and drawing of the leading ends 450 by hand. In the embodimentof FIG. 22, the pull features take the form of grips 454 that may beeasily grasped, for example, between a thumb and an index finger. Thegrips 454 may be plastic rods crimped, insert molded, adhesive bonded,or otherwise attached to the remainder of the threaders 412, 414. Inalternative embodiments, differently configured pull features may beused, including rigid rings, flexible loops, spherical beads, squaredbeads, and the like.

Additionally, each of the trailing ends 452 has a suture retentionfeature designed to retain a portion of a suture to enable the threaders412, 414 to draw the suture through the passageways 322, 323, 324, 325,328, 329 of the line lock 310. In FIG. 22, the suture retention featurestake the form of eyelets 456, each of which is able to receive an end ofthe suture such that the suture end can double back on itself to bedrawn through the cartridge 410. The eyelets 456 may be crimped,adhesive bonded, insert molded, or otherwise attached to the remainderof the threaders 412, 414. In alternative embodiments, differentlyconfigured suture retention features may be used, includingadhesive-coated surfaces, collets, clips, flexible loops, and the like.

The eyelets 456 may be retained to ensure that they are not drawn intothe cartridge 410 prior to attachment to the suture to be threadedthrough the line lock 310. For example, the containment portion 432 mayhave retention posts 458 that extend in the longitudinal direction 402on either side of each of the slots of the first set of slots 440. Eachof the eyelets 456 may optionally be looped around a pair of theretention posts 458 so that each eyelet 456 is unable to enter thecorresponding slot of the first set of slots 440 until the eyelet 456 isremoved from around the retention posts 458. Each of the eyelets 456 mayneed to be slightly larger than shown in FIG. 22 to enable them toencircle a pair of the retention posts 458. The retention posts 458 mayalso serve a similar function if loops or other flexible sutureretention features are used in place of the eyelets 456.

Referring to FIG. 23, a perspective view illustrates the system 400 ofFIG. 22, with the cartridge 410 in the open configuration to expose theline lock 310. The suture 350 has also been inserted into engagementwith the trailing ends 452 of the threaders 412, 414. More precisely, afirst suture portion 460 of the suture 350 has been inserted through theeyelet 456 of the first threader 412, and a second suture portion 462 ofthe suture 350 has been inserted through the eyelet 456 of the secondthreader 414. The first and second suture portions 460, 462 are doubledback on themselves to permit the eyelets 456 to draw them through thecartridge 410 and through the passageways 322, 323, 324, 325, 328, 329(not visible in FIG. 23) of the line lock 310.

Each of the suture portions 460, 462 may correspond to one or more ofthe various portions 352, 354, 355, 356, 357 of the suture 350. However,no direct correlation is necessary because any portion(s) of the suture350 may be drawn through the line lock 310 via the cartridge 410 and thethreaders 412, 414. In the alternative to threading two portions of asuture through the line lock 310, the system 400 may be used to threadtwo separate sutures through the line lock 310.

As shown in FIG. 23, the containment portion 432 has a pair of sockets464 formed therein. Each of the sockets 464 may provide a generallyrectangular cavity surrounded by a wall that is slotted to permitexpansion of the socket 464. The lid 430 has a pair of posts 466 thatare generally rectangular in shape, and are sized and positioned toslide into the sockets 464 when the cartridge 410 is in the closedconfiguration. The posts 466 may be sized to fit relatively tightly intothe sockets 464 so that the cartridge 410 does not open until thethreshold force is applied to remove the posts 466 from the sockets 464.

The containment portion 432 also has a central divider 470 that extendsgenerally along the lateral direction 404 to effectively separate thecontainment portion 432 into two separate compartments. The containmentportion 432 defines a retention feature designed to retain the line lock310. In this application, the terms “retention feature” and “threadingfeature” are to be broadly interpreted to include, not just singlestructural elements, but also groups of elements that cooperate to carryout line lock retention or suture threading.

In FIG. 23, the retention feature takes the form of a pair of troughs472 positioned on either side of a space in which the line lock 310rests within the containment portion 432. The troughs 472 face eachother such that they retain the periphery 318 of the body 312 of theline lock 310 to resist motion of the line lock 310 along thelongitudinal and lateral directions 402, 404. The troughs 472 areexposed on the open side of the containment portion 432 so that the linelock 310 can be inserted into the space between the troughs 472, orremoved therefrom, by moving the line lock 310 along the transversedirection 406.

Additionally, the containment portion 432 has a threading featuredesigned to help guide the suture 350 through the passageways 322, 323,324, 325, 328, 329 along the desired pattern. In FIG. 23, the threadingfeature takes the form of a pair of posts 474 positioned on either sideof the central divider 470, and thus on either side of the space inwhich the line lock 310 rests. Each of the posts 474 may have agenerally teardrop-shaped cross section, as taken through a planeparallel to the longitudinal and lateral directions 402, 404. Each ofthe posts 474 also has a slot 476 facing the adjacent one of the firstand second longitudinal ends 420, 422.

The threaders 412, 414 are wrapped around the posts 474 along aconfiguration similar to that provided by the suture 350 illustrated inFIGS. 20 and 21. More precisely, from its trailing end 452, the firstthreader 412 passes through one of the first set of slots 440, thenthrough the first primary passageway 322 (not visible in FIG. 23) andthen through the first secondary passageway 323 (not visible) to definea first loop 480 of the first threader 412. From the first secondarypassageway 323, the first threader 412 passes through the first workingpassageway 328 (not visible) to define a second loop 482 of the firstthreader 412. From the first working passageway 328, the first threader412 extends through the first loop 480 and then passes through thecorresponding one of the second set of slots 442, to the leading end450.

Similarly, from its trailing end 452, the second threader 414 passesthrough one of the first set of slots 440, then through the secondprimary passageway 324 (not visible in FIG. 23) and then through thesecond secondary passageway 325 (not visible) to define a first loop 484of the second threader 414. From the second secondary passageway 325,the second threader 414 passes through the second working passageway 329(not visible) to define a second loop 486 of the second threader 414.From the second working passageway 329, the second threader 414 extendsthrough the first loop 484 and then passes through the corresponding oneof the second set of slots 442, to the leading end 450.

The various portions of the threaders 412, 414 may be positioned tocorrespond to portions of the suture 350, as labeled in FIGS. 20 and 21.For example, the trailing ends 452 may correspond to the standingportion 352 of the suture 350, the leading ends 450 may correspond tothe working portions 354, 355, and the loops 480, 482, 484, 486 maycorrespond to the locking portions 356, 357. The first loops 480, 484 ofthe threaders 412, 414, respectively, may more precisely correspond tothe compression sections 360, 361 of the locking portions 356, 357.Accordingly, when the suture 350 is drawn through the passageways 322,323, 324, 325, 328, 329 by the threaders 412, the suture 350 assumes aconfiguration having the various portions 352, 354, 355, 356, 357 andsections 360, 361, as illustrated in FIGS. 20 and 21.

As also shown in FIG. 23, the lid 430 has a pair of blocking members 490that engage the posts 474 when the cartridge 410 is closed to keep thevarious loops 480, 482, 484, 486 in place. More precisely, each of theblocking members 490 has a longitudinal portion 492 extending along thelongitudinal direction 402, and a lateral portion 494 extending alongthe lateral direction 404. The longitudinal portions 492 may bepositioned to seat in the slots 476 of the posts 474 to ensure that theloops 480, 482, 484, 486 cannot slip from the posts 474 by movingtransversely toward the lid 430, into a gap that may exist between theposts 474 and the lid 430. Similarly, the lateral portions 494 may bepositioned inward of and adjacent to the first and second sets of slots440, 442 to ensure that the leading and trailing ends 450, 452 of thethreaders 412, 414 are unable to slide out of the slots 440, 442 bymoving transversely toward the lid 430, into a gap that may existbetween the slots 440, 442 and the lid 430.

Referring to FIG. 24, a perspective view illustrates the system 400 ofFIG. 22, with the cartridge 410 open to expose the line lock 310. InFIG. 24, the first threader 412 is drawn partially through the cartridge410 so that the corresponding first suture portion 460 of the suture 350is partially drawn through the corresponding passageways 322, 324, 328(not visible in FIG. 24) of the line lock 310.

More precisely, the first suture portion 460 has been drawn through thecorresponding one of the first set of slots 420 and through the firstprimary passageway 322 (not visible in FIG. 24) of the line lock 310.Further, the first suture portion 460 has been drawn along the firstloop 480 of the first threader 412 so that the first suture portion 460encircles the post 474 toward the second longitudinal side 422, in placeof the first loop 480.

The leading, doubled-over portion of the first suture portion 460 isthus poised to enter the first secondary passageway 324 (not visible).From the first secondary passageway 324, the first suture portion 460will then be drawn along the second loop 482 of the first threader 412,through the first working passageway 328 (not visible), and then throughthe corresponding one of the second set of slots 442 in the secondlongitudinal end 422. The leading, doubled-over portion of the firstsuture portion 460 will then protrude from the cartridge 410 and mayeasily be grasped and drawn by hand until the line lock 310 ispositioned at the desired location along the length of the first sutureportion 460.

The second suture portion 462 may be drawn through the cartridge 410 ina similar manner, as described previously in connection with thediscussion of FIG. 23. Thus, both suture portions 460, 462 may be drawnfully through the cartridge 410 and through the passageways 322, 323,324, 325, 328, 329 of the line lock 310. The suture portions 460, 462may be drawn through the cartridge 410 with the cartridge in the openconfiguration, as illustrated in FIG. 24, or with the cartridge 410 inthe closed configuration. If desired, part or all of the cartridge 410may be made translucent or transparent so that a user can easily verifyproper threading without opening the cartridge 410.

Referring to FIG. 25, a perspective view illustrates the system 400 ofFIG. 22, with the cartridge 410 in the open configuration to expose theline lock 310. The suture 350 has been fully threaded through thepassageways 322, 323, 324, 325, 328, 329 of the line lock 310 in themanner illustrated in FIGS. 20 and 21. Accordingly, the line lock 310need only be removed from the cartridge 410 prior to use to retaintissue.

Referring to FIG. 26, a perspective view illustrates the system 400 ofFIG. 22, with the cartridge 410 in the open configuration, and with theline lock 310 and the suture 350 removed from the cartridge 410 for use.The line lock 310 has been drawn from the space between the troughs 472by drawing the line lock 310 along the transverse direction 406, towardthe space the lid 430 would occupy if the cartridge 410 were closed. Thefirst and second suture portions 460, 462 are also drawn along the samedirection to slide free of the posts 474 and the first and second setsof slots 440, 442.

As shown, the various portions and sections 352, 354, 355, 356, 357,360, 361 of the suture 350 are arranged substantially as shown in FIGS.20 and 21. The standing portion 352 may connect the first and secondsuture portions 460, 461 together at a location not illustrated in FIG.26. The standing portion 352 may be inserted through an anchor embeddedin tissue, or otherwise positioned behind tissues to be retained by thesystem 400, prior to performance of the threading process set forthabove. If the standing portion 352 is not required to pass through anenclosed aperture, the standing portion 352 may be positioned withrespect to the tissue to be retained after the suture 350 has beenthreaded through the line lock 310.

In alternative embodiments, the first and second suture portions 460,462 may be two separate lengths of suture. The first and second sutureportions 460, 462 may then be attached to their respective anchorpoints, or to each other, before or after they are threaded through theline lock 310. If desired, the first and second suture portions 460,462, as separate sutures, may be attached to two different anchor pointsand the line lock 310 may be applied to draw the anchor points, andthereby the connected tissues, together.

As another alternative, the line lock 310 may only receive a singlesuture portion via the cartridge 410 and one of the threaders 412, 414.Such a single suture portion may be attached to an anchor at one end andtightened via the line lock 310 to retain tissue. As yet anotheralternative, a differently configured line lock (not shown) may beretained within the cartridge 410 to receive a single suture portion.Such a line lock may operate as the functional equivalent of the linelock 310, and may thus have only the first passageways 322, 324, 328.

Returning to the configuration of FIG. 26, once the suture 350 has beenproperly threaded through the passageways 322, 323, 324, 325, 328, 329(some of which are not visible in FIG. 26), the line lock 310 may thenbe used to retain the tissue as desired. This may be accomplished byfollowing the procedures outlined previously, i.e., holding the workingportions 354, 355 and advancing the line lock 310 along the suture 350to constrict the standing portion 352, either with or without aninsertion tool, and then trimming the suture 350.

Thus, the suture 350 may easily be threaded through the line lock 310 inthe proper pattern to ensure that the line lock 310 is able to performas desired. Threading may be performed without significantlycompromising the sterility of the line lock 310, the suture 350, or theoperating environment. Thus, the convenience, reliability, and safety oftissue retention operations may be enhanced through the presentinvention.

The present invention has particular relevance to surgery, and moreparticularly to tissue retention through the use of sutures. However,the principles, structures, and methods of the present invention mayalso be extended to other fields, including the use of larger line locksfor locking ropes or cables in a wide variety of applications.

The present invention may be embodied in other specific forms withoutdeparting from its spirit or essential characteristics. For example,above are described various alternative examples of different adjustableline locks. It is appreciated that various features of the line lockscan be mixed and matched to form a variety of other alternatives, eachof which may have a different threading system according to theinvention. As such the described embodiments are to be considered in allrespects only as illustrative and not restrictive. The scope of theinvention is, therefore, indicated by the appended claims rather than bythe foregoing description. All changes which come within the meaning andrange of equivalency of the claims are to be embraced within theirscope.

1. A system for inserting a suture through passageways of a line lock,the system comprising: a cartridge comprising: a retention featureshaped to retain a line lock comprising a body at least partiallybounding a plurality of passageways; and a threading feature shaped tofacilitate insertion of the suture through the passageways.
 2. Thesystem of claim 1, wherein the cartridge is shaped to substantiallyenclose the line lock.
 3. The system of claim 2, wherein the cartridgefurther comprises a lid that is movable with respect to a remainder ofthe cartridge to open the cartridge to permit removal of the line lockfrom the cartridge.
 4. The system of claim 1, wherein the retentionfeature comprises a pair of troughs positioned on either side of a spaceinto which the line lock fits, wherein the troughs are shaped torestrict motion of the line lock along two perpendicular axes.
 5. Thesystem of claim 4, wherein the threading feature comprises a pair ofposts positioned on either side of the space, wherein the posts aredisplaced from each other along a first direction substantiallyperpendicular to a second direction along which the troughs aredisplaced from each other such that the suture can move around andbetween the posts to move through the passageways along a first pathway.6. The system of claim 1, further comprising a first threader routedthrough the passageways along a first pathway via at least partialencirclement of the threading feature such that the first threader isdrawable to draw a first locking portion of the suture through thepassageways along the first pathway.
 7. The system of claim 6, whereinthe first threader comprises a leading end having a pull feature thatfacilitates grasping and pulling of the leading end by hand, and atrailing end having a suture retention feature that retains a portion ofthe suture to permit the trailing end to draw the suture.
 8. The systemof claim 6, further comprising a second threader routed through thepassageways along a second pathway via at least partial encirclement ofthe threading feature such that the second threader is drawable to drawa second locking portion of the suture through the passageways along thesecond pathway.
 9. The system of claim 8, wherein the first pathwayextends through first primary, secondary, and locking passageways of theline lock, wherein the second pathway extends through second primary,secondary, and working passageways of the line lock.
 10. The system ofclaim 6, further comprising the line lock.
 11. The system of claim 10,wherein the passageways are arranged to receive the suture such that thesuture is able to be drawn through the passageways along only onedirection.
 12. The system of claim 10, wherein the line lock isgenerally disc-shaped.
 13. A system for retaining tissue, the systemcomprising: a line lock comprising a body at least partially bounding aplurality of passageways; and a first threader passing through thepassageways along a first pathway, the first threader comprising asuture retention feature shaped to retain a portion of a suture to drawthe suture along the first pathway in response to motion of the firstthreader along the first pathway; wherein the passageways are arrangedto permit the suture to be drawn along the first pathway substantiallyonly along one direction.
 14. The system of claim 13, wherein the firstthreader comprises a leading end having a pull feature that facilitatesgrasping and pulling of the leading end by hand, and a trailing endhaving the suture retention feature.
 15. The system of claim 14, whereinthe suture retention feature comprises a loop sized to grasp the suturein response to tension on the first threader.
 16. The system of claim13, wherein the portion of the suture comprises a first locking portionof the suture, the system further comprising a second threader passingthrough the passageways along a second pathway, the second threadercomprising a suture retention portion shaped to retain a second lockingportion of the suture to draw the second locking portion along a secondpathway in response to motion of the second threader along the secondpathway.
 17. The system of claim 16, wherein the passageways comprisefirst primary, secondary, and locking passageways and second primary,secondary, and locking passageways, wherein the first pathway extendsthrough the first primary, secondary, and locking passageways and thesecond pathway extends through the second primary, secondary, andworking passageways.
 18. The system of claim 13, wherein the passagewaysare arranged to receive the suture such that the suture is able to bedrawn through the passageways along only one direction.
 19. The systemof claim 13, further comprising a cartridge shaped to substantiallyenclose the line lock and the first threader.
 20. The system of claim19, wherein the cartridge comprises a retention feature shaped to retainthe line lock, and a threading feature shaped to guide the firstthreader along the first pathway.
 21. A system for inserting a suturethrough passageways of a line lock, the line lock comprising a body atleast partially bounding the passageways, the system comprising: acartridge comprising a threading feature; and a first threaderpositioned at least partially within the cartridge such that the firstthreader can be drawn along the threading feature to move the firstthreader along a first pathway through the passageways to draw thesuture along the first pathway.
 22. The system of claim 21, wherein thecartridge is shaped to substantially enclose the line lock, wherein thecartridge further comprises a lid that is movable with respect to aremainder of the cartridge to open the cartridge to permit removal ofthe line lock from the cartridge.
 23. The system of claim 21, whereinthe retention feature comprises a pair of troughs positioned on eitherside of a space into which the line lock fits, wherein the troughs areshaped to restrict motion of the line lock along two perpendicular axes.24. The system of claim 23, wherein the threading feature comprises apair of posts positioned on either side of the space, wherein the postsare displaced from each other along a first direction substantiallyperpendicular to a second direction along which the troughs aredisplaced from each other such that the suture can move around andbetween the posts to move through the passageways along a first pathway.25. The system of claim 21, wherein the first threader is routed throughthe passageways along a first pathway via at least partial encirclementof the threading feature such that the first threader is drawable todraw a first locking portion of the suture through the passageways alongthe first pathway.
 26. The system of claim 25, wherein the firstthreader comprises a leading end having a pull feature that facilitatesgrasping and pulling of the leading end by hand, and a trailing endhaving a suture retention feature that retains a portion of the sutureto permit the trailing end to draw the suture.
 27. The system of claim25, further comprising a second threader routed through the passagewaysalong a second pathway via at least partial encirclement of thethreading feature such that the second threader is drawable to draw asecond locking portion of the suture through the passageways along thesecond pathway.
 28. The system of claim 27, wherein the first pathwayextends through first primary, secondary, and locking passageways of theline lock, wherein the second pathway extends through second primary,secondary, and working passageways of the line lock.
 29. The system ofclaim 21, further comprising the line lock.
 30. The system of claim 29,wherein the passageways are arranged to receive the suture such that thesuture is able to be drawn through the passageways along only onedirection.
 31. A system for retaining a line lock, the systemcomprising: a cartridge comprising: a retention feature shaped to retaina line lock, the line lock comprising a body at least partially boundinga plurality of passageways arranged to receive a suture; and a lidmovably attached to a remainder of the cartridge such that the lid andthe remainder of the cartridge cooperate to substantially enclose theline lock, wherein the cartridge is openable via pressure against thelid to permit removal of the line lock from the cartridge.
 32. Thesystem of claim 31, wherein the cartridge is formed substantially ofrigid plastic, the cartridge further comprising a living hingepositioned to permit pivotal motion of the lid with respect to theremainder of the cartridge.
 33. The system of claim 32, wherein thecartridge further comprises a latch positioned to keep the lid frompivoting open with respect to the remainder of the cartridge until athreshold force is applied.
 34. The system of claim 31, wherein theretention feature comprises a pair of troughs positioned on either sideof a space into which the line lock fits, wherein the troughs are shapedto restrict motion of the line lock along two perpendicular axes. 35.The system of claim 31, wherein the cartridge further comprises athreading feature shaped to facilitate insertion of the suture throughthe passageways.
 36. The system of claim 35, wherein the threadingfeature comprises a pair of posts positioned on either side of a spaceinto which the line lock fits such that the suture can move around andbetween the posts to move through the passageways along a first pathway.37. The system of claim 35, further comprising a first threader routedthrough the passageways along a first pathway via at least partialencirclement of the threading feature such that the first threader isdrawable to draw a first locking portion of the suture through thepassageways along the first pathway.
 38. The system of claim 37, furthercomprising a second threader routed through the passageways along asecond pathway via at least partial encirclement of the threadingfeature such that the second threader is drawable to draw a secondlocking portion of the suture through the passageways along the secondpathway.
 39. The system of claim 38, wherein the first pathway extendsthrough first primary, secondary, and locking passageways of the linelock, wherein the second pathway extends through second primary,secondary, and working passageways of the line lock.
 40. The system ofclaim 35, further comprising the line lock, wherein the passageways arearranged to receive the suture such that the suture is able to be drawnthrough the passageways along only one direction.
 41. A method forpreparing a line lock to retain tissue, the line lock comprising a bodyat least partially bounding a plurality of passageways, the methodcomprising: inserting the suture through the passageways; and removingthe line lock from a cartridge after insertion of the suture through thepassageways.
 42. The method of claim 41, wherein the cartridge is shapedto substantially enclose the line lock, wherein the cartridge furthercomprises a lid, the method further comprising moving the lid withrespect to a remainder of the cartridge to permit removal of the linelock from the cartridge.
 43. The method of claim 41, wherein theretention feature comprises a pair of troughs positioned on either sideof a space into which the line lock fits, wherein removing the line lockfrom the cartridge comprises sliding the line lock out from between thetroughs.
 44. The method of claim 43, wherein the cartridge comprises athreading feature, wherein inserting the suture through the passagewayscomprises utilizing the threading feature to facilitate insertion of thesuture through the passageways.
 45. The method of claim 44, wherein thethreading feature comprises a pair of posts positioned on either side ofthe space, wherein the posts are displaced from each other along a firstdirection substantially perpendicular to a second direction along whichthe troughs are displaced from each other such that the suture can movearound and between the posts to move through the passageways along afirst pathway.
 46. The method of claim 44, further comprising routing afirst threader through the passageways along a first pathway via atleast partial encirclement of the threading feature, wherein utilizingthe threading feature to facilitate insertion of the suture through thepassageways comprises drawing the first threader to draw a first lockingportion of the suture through the passageways along the first pathway.47. The method of claim 46, wherein the first threader comprises aleading end having a pull feature, and a trailing end having a sutureretention feature, wherein drawing the first threader comprises:retaining a portion of the suture with the suture retention feature;grasping the pull feature; and pulling the pull feature by hand to drawthe threader.
 48. The method of claim 46, further comprising routing asecond threader through the passageways along a second pathway via atleast partial encirclement of the threading feature, wherein utilizingthe threading feature to facilitate insertion of the suture through thepassageways comprises drawing the second threader to draw a secondlocking portion of the suture through the passageways along the secondpathway.
 49. The method of claim 48, wherein the passageways comprisefirst primary, secondary, and working passageways and second primary,secondary, and working passageways, wherein routing the first threaderalong the first pathway comprises routing the first threader through thefirst primary, secondary, and locking passageways, wherein routing thesecond threader along the second pathway comprises routing the secondthreader through the second primary, secondary, and working passageways.50. The method of claim 41, wherein inserting the suture through thepassageways comprises positioning the suture such that the suture isable to be drawn through the passageways along only one direction.
 51. Amethod for preparing a line lock to retain tissue, the line lockcomprising a body at least partially bounding a plurality ofpassageways, wherein a first threader passes through the passagewaysalong a first pathway, the method comprising: retaining a portion of asuture with the first threader; and moving the first threader along thefirst pathway to draw the portion of the suture along the first pathwayalong one direction such that the first suture is substantially unableto be drawn along the first pathway counter to the first direction. 52.The method of claim 51, wherein the first threader comprises a leadingend having a pull feature, and a trailing end having a suture retentionfeature, wherein retaining the portion of the suture with the firstthreader comprises retaining the portion of the suture with the sutureretention feature, wherein moving the first threader along the firstpathway comprises: grasping the pull feature; and pulling the pullfeature by hand to draw the threader.
 53. The method of claim 52,wherein the suture retention feature comprises a loop, wherein retainingthe portion of the suture with the suture retention feature comprisesgrasping the portion of the suture with the loop in response to tensionon the first threader.
 54. The method of claim 51, wherein the portionof the suture comprises a first locking portion of the suture, themethod further comprising: retaining a second locking portion of thesuture with a second threader passing through the passageways along asecond pathway; and moving the second threader along the second pathwayto draw the second locking portion along the second pathway.
 55. Themethod of claim 54, wherein the passageways comprise first primary,secondary, and working passageways and second primary, secondary, andworking passageways, wherein moving the first threader along the firstpathway comprises moving the first threader through the first primary,secondary, and locking passageways, wherein moving the second threaderalong the second pathway comprises moving the second threader throughthe second primary, secondary, and working passageways.
 56. The methodof claim 51, wherein inserting the suture through the passagewayscomprises positioning the suture such that the suture is able to bedrawn through the passageways along only one direction.
 57. The methodof claim 51, wherein the line lock and the first threader aresubstantially enclosed within a cartridge, wherein drawing the portionof the suture along the first pathway comprises drawing the portion ofthe suture into the cartridge.
 58. The method of claim 57, wherein thecartridge comprises a retention feature and a threading feature, whereindrawing the portion of the suture along the first pathway comprisesretaining the line lock via the retention feature and guiding the firstthreader along the first pathway via the threading feature.